The first warnings were anecdotal; the second, statistical.
An unusual number of people who needed to detox from alcohol couldn’t do so at the Texas Health Recovery and Wellness Center, said Sandy Potter, who oversees the center. They were too sick. Instead, they detoxed in the hospital — a sign their illness had rendered them “medically fragile,” she said.
When Potter, who’s also the vice president of behavioral health for the Texas Health system, sat down to compile the data for the first three months of 2022, the numbers were similarly chilling. Almost as many people had died in a Texas Health emergency room or hospital from an alcohol-related condition in the first quarter of this year as the entire year in 2021. She and her boss at the time, Winjie Tang Miao, began to problem-solve.
“How can we get in touch with somebody who might have earlier access to individuals, before they get to the point where they’re having to go to the emergency room?” Potter said. “And, of course, Texas Health being a faith-based organization, the first ones we thought of were pastoral care individuals: clergy, chaplains who meet people every day.”
In response to the uptick in alcohol-related deaths, the hospital system’s behavioral health and pastoral care departments collaborated to equip leaders in faith-based groups around North Texas to screen people who might be struggling with alcohol or other substances. The virtual training, which Potter hopes is the first of many, took place May 12.
“This is an illness that stays in the shadow,” she said. “So in any way we can reduce the stigma, that allows people to have more open and honest conversation — that’s going to help not only this community but all of us.”
- SAMHSA behavioral health treatment services locator: Type in your zip code to find behavioral health treatment centers near you.
- Alcoholics Anonymous: Find support groups where people struggling with alcohol help each other.
- Texas Health Recovery and Wellness Center: Call 682-812-6150 for a free assessment related to substance use.
Increased alcohol consumption in the pandemic
Emerging research since March 2020 suggests that alcohol consumption increased during and because of the COVID-19 pandemic.
By May 2020, 60% of participants said they’d increased drinking since the pandemic began, citing increased stress, access to alcohol and boredom, according to a 2020 study in the International Journal of Environmental Research and Public Health. The study is limited: The respondents were mainly white women under 50.
A more recent study confirmed and expanded those results. More than half of participants said they were drinking more by November 2020 than they were in February 2020. On average, the number of drinks they consumed per month had more than doubled. In general, the increases affected people regardless of race or gender.
‘Humanness and brokenness and frailty’
Potter thinks the deaths she’s seeing this year are related to those shifting habits early in the pandemic. After her analysis, she reached out to Rev. Elizabeth Watson-Martin, the vice president of faith and spirituality integration at Texas Health. Watson-Martin works to “lay claim” to the hospital system’s faith-based roots, she said.
The system’s Faith Community Nursing program, for example, partners with registered nurses within a specific congregation to provide programs tailored to that congregation’s needs. And, when new patients visit a Texas Health hospital, nurses conducting intake ask those patients if their “faith or life outlook … whatever orients them” is working for them, she said.
“Do you feel a sense of belonging? That there’s someone that owns you, loves you? Is the universe friendly toward you? Do you feel like you have a place? Or are you not feeling that way?” she said. “And again, if you’re not feeling that way, it really impacts your outlook and how you’re willing to engage your healing process.”
Before the pandemic, Watson-Martin’s department also offered regular trainings to clergy who visited hospitalized church members. The pandemic temporarily shut those visits down, she said. The virtual training in May is the first of its kind since the pandemic began. Close to 50 people, many of them clergy, participated.
They left with the CAGE-AID screening tool: four yes-or-no questions that help someone determine whether a more formal referral could benefit the person answering. The tool has been around for decades, and laypeople can use it.
“When I do training, I want to give people a tool they can use, because you don’t remember all the dialogue when you’re in a training,” Potter said. “But if you’re given something tangible that you can take and use in your day-to-day work, I think that’s powerful.”
Equipping clergy made sense, Watson-Martin said, because many have already formed trusting relationships within their communities. She acknowledges that some people may not feel comfortable sharing their substance use with a spiritual leader — that’s why the training encouraged clergy to approach conversations about substance abuse with a posture of humility.
“I really wanted to bookend that presentation with a call to clergy to be aware of their own humanness and brokenness and frailty,” she said, “which then allows them to enter in humbly to meet people and not evoke — they’re already shamed — let’s not evoke any more shame or judgment.”
‘We just needed to probe a little bit more’
For Shirley Roberts, the nurse manager at GRACE Community Clinic in Grapevine, the training was “eye-opening.”
She’s not clergy, but GRACE is a faith-based nonprofit that helps people who struggle to meet their basic needs. The clinic she oversees provides care to hundreds of people without medical insurance each year; in June alone, it supported about 500 patient visits.
When a new patient joins the clinic, Roberts speaks with the patient about their medical history and health needs. Until the Texas Health training, that intake session included limited questions about substance use. “We just needed to probe a little bit more,” she said.
Since the training, Roberts has implemented the CAGE-AID questions during patient intake sessions. Already, she’s been able to refer people to a mental health professional for further assessment.
“We’re at the beginning: The eye-opener, the decision to implement and now we’re going forward,” she said. “I think we’ve got work to do, but I’m excited.”
Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.